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Photo by M. Scott Moon
Jane Madison, right, presents testimony Thursday night against a proposed ambulatory surgery center during a meeting held by the Alaska Department of Health and Social Services at the Challenger Center of Alaska.

Kahtnu meeting draws standing room crowd

Posted: January 20, 2012 - 1:47pm  |  Updated: January 21, 2012 - 9:44pm
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Photo by M. Scott Moon
Henry Krull, one of the eight local doctors who formed Kahtnu Ventures, presents the group’s case for the center at the beginning of the meeting.

A standing room-only crowd weighed in Thursday on Kahtnu Venture’s proposal to build a surgical center in Kenai before Alaska Department of Health and Social Services officials.

Karen Lawfer, state certificate of need coordinator, said about 35 testimonies were gathered from the crowd that filled the Challenger Learning Center in Kenai. 

Residents testified both in favor and against Kahtnu’s proposal to build the 8,365 square foot building estimated at $9 million.

Central Peninsula Hospital is fighting the surgery center idea on the grounds that it would take away one of the more profitable service lines it offers, thus damaging their less profitable areas and the hospital overall.

Kahtnu is heralding the proposal as a choice for health care consumers that would lower the cost of outpatient surgeries and prevent medical out-migration to Anchorage.

So many people attended the meeting that a number of others were turned away at the door because the building was at capacity.

Clam Gulch resident Joann Odd said she had to pay someone to drive her the 45 minutes from her home to Kenai, but was angered when she was turned away at the door.

“I was met at the door along with a number of other people and (someone) said, ‘You can’t come in,’” she said. “I said, ‘What?’”

“They had such a turnout last night that they should have moved it next door to the auditorium because everybody was being turned away and this was like 15 minutes after 5 p.m.”

Odd said she wanted the state to schedule another meeting so she and the many others turned away could speak to the issue.

Lawfer offered an apology to those who weren’t able to testify.

“I had no idea there were going to be that many people there and that was going to happen,” she said. “I can tell you that it has never happened in the past.”

However, there won’t be another public comment meeting scheduled, she said.

“No, I can’t have another meeting because I literally at the end of the comment period, we basically shut everything down and do a thorough review of the application,” she said. “I can’t get another public meeting set up, but people still have a chance to give me comments.”

Among those residents that got in the building and spoke was Steve Doneth who supported Kahtnu’s request.

“Free enterprise — these gentlemen want to spend their money, that’s their right,” Doneth said. “It is called America.”

Doneth explained the state should be “continually” looking for economic growth.

“So just get out of their way,” he said. “It is so simple. Let them build the building.”

Jane Madison said she was against the proposal for a number of reasons.

“I have been totally impressed with Central Peninsula Hospital,” she said. “I love the hospital … and I want it to be successful and grow. It is by far one of the best hospitals in the nation. I do not want to see any entity establish any business that either unnecessarily duplicates hospital services or steals patients and personnel away. The Kahtnu center does both.”

Many residents encouraged CPH officials and the eight local surgeons representing Kahtnu to collaborate.

“The hospital and Kahtnu somehow, some way need to work together because we are a small enough community that this shouldn’t be a political race or an argument,” said Leslie Marcon. “Everyone should work together for the patients. We are a small place and we all need everything.”

John Parker agreed, citing economic and population concerns.

“That’s what I see we are facing with our hospital — it is growing, they have always done a very good job, but I support the Kahtnu center not because we need an alternative but an addition,” he said. “I would encourage CPH to work with the surgery center and make it a part of our whole community.”

Linda Duce echoed a similar sentiment, but added that “despite the fear of change” she was leaning more toward Kahtnu’s proposal.

“It should be noted as it relates to the potential bleeding off of revenue that Kahtnu did invite CPH to participate at the outset and were declined,” she said. “As our population changes, and that should read also as we age, there are things that are needed … these eight surgeons … can do something to impact outpatient surgeries and costs and the needs of the community.”

Charlotte Micheltree addressed issues of out-migration. She said she knows a number of Peninsula residents that have recently had surgeries.

“Guess what? We all went out of the area for whatever reason,” she said.

Micheltree held a sign at her feet reading, ‘Please, give me a local choice ...’

“The only thing that I am arguing is that when they are saying, ‘Oh there is not that many people leaving the area to get medical help,’” she said. “I still go to Anchorage to get quite a few things. I think there is room for both here. They keep bringing in all these new doctors, but where are we going to put them?”

Both the Kenai and Soldotna City Councils heard from Kahtnu and CPH officials during their respective Wednesday meetings. One took action against the center and one remained neutral on the subject.

At Thursday’s meeting, Kenai Mayor Pat Porter spoke to state officials about the city’s consideration of Kahtnu’s proposal.

“Originally when all of this began I was told it was not a political process so I chose not to bring a resolution to the city council of Kenai and to allow the certificate of need to be shown on the merits of whether it was needed or not, and not become a political issue,” Porter said. “But obviously it has.”

Porter then spoke in favor of the center, but clarified she was speaking as an individual and not as the mayor of Kenai.

The Soldotna City Council hosted a special Wednesday meeting and passed a resolution opposing the certificate of need for Kahtnu’s proposal, mayor Peter Micciche said.

“No one opposed the proposal, the council simply took the opportunity outlined in the certificate of need process to discuss the potential effects on the city and on Soldotna taxpayers and whether or not there was a need for an additional operating room,” he said, adding there is no “ill will” to those involved with Kahtnu.

The vote was 4-2 in favor of the resolution, which states the surgery center would “duplicate already available health care facilities and would jeopardize community health planning that has been conducted by the Kenai Peninsula Borough and CPH for over 40 years.”

“I think something that is really important is that this is a service area issue, it is not a Soldotna – Kenai issue,” Micciche said.

Added Micciche, “In my view, and apparently the view of the council, this is protecting our taxpayers who work very hard to keep tax burden down in Soldotna and we fear this could increase taxes to continue providing those services in the future.” 

Kahtnu takes action against CPH’s 4th operating room

Details also emerged Thursday of a new development in the consideration of Kahtnu Venture’s proposal.

Stephen Rose, an attorney with the Seattle-based law firm Garvey Schubert Barer, confirmed Kahtnu is seeking an injunction against the Department of Health and Social Services, with CPH listed as a party.

The group of eight surgeons is taking issue with the development and completion of CPH’s fourth operating room, which has become a point of consideration surrounding whether or not Kahtnu’s proposal is needed in the area.

“Kahtnu Ventures brought an action seeking an injunction against the Department of Health and Social Services asking to address the opinion that Karen Lawfer issued stating that the hospital did not need a certificate of need to build the fourth operating room,” Rose said. “After we filed that action for an injunction, I spoke with the attorney representing the (state) department and it was her suggestion that since this was something that impacted the hospital that we bring (them) in as a party.”

Rose said Kahtnu has questions about whether all of the costs to build CPH’s operating room were included in the state’s determination. They would like an independent voice to determine if the decision was indeed correct.

“We have filed an appeal of that decision and that we have sufficient time to have an independent judge hear our case and render a decision,” Rose said. “If we lose on that administrative appeal then so be it. But, we would like to have someone non-biased review her decision.”

CPH Chief Executive Officer Rick Davis explained the hospital originally obtained a CON for four surgery rooms when it started an expansion project several years ago, but never completed the fourth room, which was scheduled to become available in May. Davis said the cost of the OR was below the minimum to require a CON.

“It just begs the question of why they think it makes more sense to build a $9 million OR than the $900,000 OR when they are willing to sue us in order to make that happen,” he said.

“This is just a delay thing for them to try and get their CON approved with only using (our three surgery rooms in the calculation),” Davis said. “Ultimately we will get our fourth OR built, but they’re just trying to delay it.”


Public comment period is open through 4:30 p.m. Monday.


Karen Lawfer

CON Program Coordinator

Division of Health Care Services

P.O. Box 110660

Juneau, AK 99811


• A staff analysis of the application and recommendation must be submitted to the commissioner of the Division of Health Care Services by Feb. 19 unless additional time, not to exceed 30 days, is granted by the commissioner. A decision by the commissioner must be made within 45 days of receipt of the staff recommendation unless additional public notice is given that additional information or analysis is required by the commissioner to make a decision.

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bewildered 01/20/12 - 02:25 pm
I find it entertaining that

I find it entertaining that most of these comments are from the patients of these surgeons.

liftit 01/20/12 - 10:40 pm
I read this comment to my

I read this comment to my grandmother-in-law and mother-in-law, and asked them if they agreed:

"I have been totally impressed with Central Peninsula Hospital,” she said. “I love the hospital … and I want it to be successful and grow. It is by far one of the best hospitals in the nation"

Both of them have needed lots of medical care throughout their lives, and both of them answered that question with a "Hell NO!".

I understand this is just another anecdote, but I can assure you that they aren't the only ones. I've had to visit them while recovering from surgery, and I just haven't been impressed with the care they received. When I compare it with the care I received at a surgery center up in Anchorage, CPGH fails in comparison. I never waited for anything, the staff was friendly and the nurses were always happy and quick to help.

sparky 01/21/12 - 01:11 pm

I don't think that Kahtnu will hurt the Hospital.I don't think they can.I do think that they would be an asset to our community.

RaySouthwell 01/22/12 - 12:24 pm
Why ?

According to this published story- CPH CEO-Rick Davis states-”It just begs the question of why they think it makes more sense to build a $9 million OR than the $900,000 OR when they are willing to sue us in order to make that happen,” he said.”

So ask the question. Why are the surgeons willing to risk $9 million to build and Ambulatory Surgery center?

Answer- to keep control of their medical practices. The Hospital Corporate Board gave the surgeons a choice. “Our way or the highway.”

The independent surgeons have found another choice. A large percentage of the population support the surgeons because the community understands the abusive management style at CPH.

Politicians do not have a clue and refuse to listen to the root cause of the problems at our public community hospital.

I wish my gardening friend, Jane Madison, would ask me the question-why?

Allen 01/22/12 - 03:56 pm
Kenai Mayor Has No Business Testifying

It's outrageous that Kenai Mayor Pat Porter would testify at this hearing. She has no power to express the opinion of the City of Kenai on this topic, she is only one Council member. The Kenai City Council did not express support for this project. It stayed neutral, and Porter should have, too.

Her trying to have it both ways, pretend she is just testifying in favor as a a private citizen but reminding us she is mayor, is a disgusting display of hypocrisy. I am sick of politicians acting this way.

kenairiverbandit 01/22/12 - 09:08 pm
call me stupid but isnt the hospital

isnt the hospital NON profit?

"Central Peninsula Hospital is fighting the surgery center idea on the grounds that it would take away one of the more profitable service lines it offers, thus damaging their less profitable areas and the hospital overall."

if so, then how are they supposed to "lose profit" if the Kahtnu clinic goes in? they are coming in for the community so i think the community has the right to decide rather or not they want it. let the people speak.

analaskancitizen 01/23/12 - 12:50 pm
response to ray

Ray, I confess that I filter each of your comments in your innumerable letters and testimonies through your Alaska Militia and Michigan Militia history. It is possible that could be why many people you disparage are not willing or interested in engaging in a dialogue with you. And yes, that keeps me from wanting you to know who I am as well. It's a matter of my being prudent.

RaySouthwell 01/23/12 - 07:33 pm

I am sorry some people do not like the color of my skin or my religious beliefs or my Constitutional understanding.

Perhaps people should quit listening to the news media and judge me on the content of my character. I know Jane Madison has. I also know the people at the National Labor Relations Board have.

When people use ad hominem attacks I get angry. You do not know, what I know, and the damaged done to many good employees at CPH.

As a parent I believed in the policy “don’t ask don’t tell.” I think our elected politicians feel the same way concerning the management style at CPH. They do not ask and do not want to know. After all just like a parent,if you knew the truth you would have to do something about it.

Politicians are more concerned about their careers than the people at CPH. I on the other hand care about the people first-everything else comes in second place. My poor wife, she tolerates me-God Bless her.

I just wish individuals like you would quit looking at false information and listen to the issues surrounding the hospital. We are going to lose our hospital, based on the management style. I have seen this coming for years and shouted the alarm. It will only get worse.

corinnep 01/23/12 - 11:01 pm
Nonprofits can make profits

kenairiver bandit asks aren't nonprofits supposed to make no profit? The answer is: nonprofits can make profits. They just can't give the profits to private individuals, they have to put the profits back into the company.

corinnep 01/23/12 - 11:24 pm
Ray Southwell has no credibility

Mr. Southwell, I wish you would stop attacking people who disagree with you. We're not stupid or looking at false information or not listening to the issues. We just disagree with your opinions. And your comments are just that - your opinions.

RaySouthwell 01/24/12 - 06:37 am

You are correct. We all have opinions.

Opinions are based on facts or emotion.

My opinion is based on the facts, I have, concerning the management style at CPH. If I am allowed to have my day in Court, the facts will come out. I hope you will come to the trial.

Norseman 01/24/12 - 08:29 am
shouting the alarm

ray, you are guilty of "shouting the alarm" on many occasions.
Your history has shown exactly that. You and your militia leader, norm olson , have done this for the past 15 years on many topics.
How many times have we seen or heard that the end is near so prepare for armageddon. That is the militia's battle cry, "The end is near", so join us or else.....

As the above poster stated, "you have no credibility" rings true. You were hired, then fired by our community owned hospital and are obviously very upset over this.

Trying to tie the surgical center into an arguement over management styles is absurd. That is for you to push your own agenda and has nothing to do with reality.

The reality is this. MONEY and PROFIT period.
Why that should concern taxpaying borough residents is because we own our hospital. To have a private for profit take away the surgeries that would be performed at the hospital, will be a death sentence for CPGH.

This is as simple as it gets. If I was a surgeon intent on maximizing my profits, I'd be doing the same thing. When you own the entire process you own 100% of the profits.

If we lose the money that would have been paid to CPGH, then it is just a matter of time before our taxes will increase dramatically each year to try and keep pace.

Carver 01/24/12 - 10:01 am
Profits: what to do with them?

You're right, corinnep, CPH should be putting their profits back into the company. Why then aren't they? As the area's other paper noted:

"Central Peninsula Hospital’s . . practice of donating money to nonprofit organizations and sponsoring various community events has some in the community questioning . . whom should receive that support.

"Financial support to one organization in particular, the Kenai River Sportfishing Association and its Kenai River Classic fishing event, has raised eyebrows over the hospital’s practice of giving financial support to nonprofits, when the organization that runs the Kenai Peninsula Borough-owned hospital, Central Peninsula General Hospital, Inc., is a nonprofit itself. . .

"CPGH, Inc. spends $75,000 to $100,000 a year in sponsoring community events and donating to nonprofit organizations, said Tom Boedeker, president of the CPGH, Inc., board of directors. The money comes from hospital operations, not tax dollars, Boedeker said. . ."

CPGH Inc. has forgotten the original mission of CPH as a place for docs to ply their trade. CPGH Inc. has placed CPH in competition with independent, area docs, and Inc. has taken upon itself to become a vehicle of patronage to area entities such as the Food Bank, Kenai Watershed Forum, and Kenai River Sportfishing Association.

Not good. Not good at all.

bewildered 01/24/12 - 12:19 pm
Ray, You have lost all

Ray, You have lost all crediblity and now just look crazed.

RaySouthwell 01/24/12 - 04:04 pm


I assume some of you are insiders of the management team at CPH. I am also an insider and can document what I have been saying over the years.

Many of you believe the CON will stop the surgeons desire to build an ambulatory Center. It will not. This is only the beginning.

History of Certificate of Need- Supported and passed in 1964 in New York State. In 1972 Became mandated by US Congress and signed into law by president Nixon. All States had to comply.

By 1986-Free Market advocates had the federal law repealed. Depending on what you read 15 States have repealed their law of CON.

Our State Senator Tom Wagoner has supported the repeal of the CON. Local Dr. Nels Anderson ran against Wagoner , in part, because of the concern a repeal of the CON would harm our hospital.

I wonder if Tom Wagoner would introduce a bill in the State Senate to repeal CON today? I wonder if Providence Hospital would like to see CON repealed and could get support from the Senators in the Anchorage area?

I have gone on record that either option for or against Kahtnu will harm the community because it divides us.

Healthcare dollars are shrinking and our community will battle over those dollars. We will all lose in the end.

Why after 40 years of a working relationship have the surgeons taken such great risk? Many here believe it is about making more money.

It is about independent surgeons attempting to keep control of their practices.

analaskancitizen 01/24/12 - 05:59 pm
from R. S. "I am sorry some

from R. S. "I am sorry some people do not like the color of my skin or my religious beliefs or my Constitutional understanding."
Where does that come from? What is there about the color of your skin that would be disagreeable? I don't know what your religious beliefs are. We read the same Constitution.

from R.S. "I assume some of you are insiders of the management team at CPH" Is that because we don't share your opinions or because your Militia factor shouts louder than your words?

It seems perhaps a tiny bit disingenuous that you worry about the community being divided since that is advantageous to the idea that our neighbors are going to be out to get us when crisis and chaos rule and we better be ready to protect ourselves from them.

RaySouthwell 01/27/12 - 12:47 pm

Discrimination comes in many forms.

Division of the community, is the issue. Just look around the nation concerning the division between the people. Throughout the country we do not look at what the root cause of problems are. With the ongoing division come chaos.

What shall the community do when the people are divided. Destroy ourselves.

Many understand the idea of community and self reliance. If we cannot come together as people we will lose.

This division within our hospital management is destroying CPH.

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